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HomeMy WebLinkAbout0005065-Building~_ 3 N y „ v m m x A ~ ~- . Vl A . C A .- n ~ ~ .~ ' A ~ O .± ~ N ~ _ n ~ < n ~ ~? Z a A~ m w n w co N ~ ~ ~ O 'a Ul N A I n n w ~_ ~ 3 3 N •~ a = ~ D c~ c~ N o m a ~ rt_ O . ~ ca m m ~ •• ~ '~ Z w ~ w ^ O ~ UOi ^ ~ T ~ ~ N ~ ~ ^ o 00 _ ~` Q' ~ ^ D ~ ^ m ~ v ~ ~ v _ m ^ o `° ~ w ~' ^ t 1 ^ O ~ ~ A~« A (D ~ ~ D ~ o ~ c W ~ o ^ a ^ ~ 7 Q+ m Q t0 ^ ^ ~ ~ ~ ~ OD. N ~ ~ N ~ a y v? o~ ~ ;~ Q 7 'O ~ ~ (n Q O w >>~O~umi ~~ _ ~. 30 ~ fl. ~ ~ ~ y o ~ Q y N 7~ /"1 S Z ~ °'~~L~ to o A (p ~ ~ o a~ m ~~ a amd~ ~~'~ ,~ o ~~o~~o c ~ a .~,_ ° = Q- i ~ i o ~ ? w w (~, X a? o ~wa° V .~. ~=fin o, w 7 (D -' C ~m:'~ ' p ~ ~ f D n Cif 7 F (~D ~ a ^ a N m y ?'~~ N m~ X a ° ~ ~ o ~ w_ ~Q n~1 Q_ 6~p i a ~~~ ~ ° m ~ S ~ ~ ~ V1 'rt x w f D ym~ ~ r n C 6 a O n. '<w j fD ~ O N w ~ n ° ~ te O O ~ Q' c~ - N ~ ~ A O ~ n s b a n' tp r. ,, a F ~ ~ j w ~ o ~ N ~ y ~ A• Q F O ~ v ~ ~ ~ ~G ~ ~ m ~ N c N ~ T 1 '0 N m a a O C ~ x O ~~? 1 < 70 Fay N ~ = ~ ! =ao' ~ m w ~ `~ w 3cDm =, 1 _ a w ~ ~ ~A W ~ c ~ ~ $o~; v cQ ~ O ~ N mi . mic ~cng~g~aog 3 ° m ~ m ~' ~ m Q (~D ~ ~ ~ ~ -~ ~ j~ 2~ n W C fA cfl m ~ w ~ m ~ ~' ~ I I I I oo ~ r v~ ?~ Q ~ ~ ? ~ ° `~ a ~ w ~ ~ v o ~ ~ ~ v ~ ~ ~ I ? I I o ~ (n ~ (n C 7 ~ '~ n ~ 7 n ~ ~ v ~' w .+ w O N W w ~ W ~ ~ fn ~ ~ Z ~ m ~ ~ ~ n -, O Z -I a O ~~ C C ~Q o ~~ c c . w a~i ,.~ ,..t. O O C7 C7 ~ C C cD ~ Q y Depth of Lot ti Yd W 13/. ~~- a 0 r T D (~ ~ Z A ~ w O ~ 0 0 ~ ~ m A ~ ~ I ~ ~ °o ~! ?: C m O 0 ~ r ~ o O (~D a _ a 00 a ~ '~ m a o ~ ~ m I m ~ ~ ~ r 0 ~_ a~ O ICJ = Z ( _) "v ^ ~ Z ~ ~ w ~ ~. 3 O ~ t~ ~ v ~_ ~ ~ ~ 3 a ^ <. ~ p ~ w o ~ O ~ d~ m ~1 ~` O ~ ~ T ~ ~ ~ ~~ m ~ o ~ C -« . ~ ~ Z ~ 7 O 7 '~ C fD (~D `.~ ~ a ~ m (~ X O m' N w s W w m ~ O ,-. ~ ~ a ~ O ~ C o ~ c m m c ,.. a w (D O w ~ m ~ m ~ i m a m m A 7 ~Q A A c v w n i ~ r, O ' ~ 7 . D tQ i 1 ~ m I o _ ~ $- °- z v ~ Z io w w o m ~ .1 u, ~ O G _~ .~. ~ . , ~:. i'~ ,. ~ _..r'.-~ ~ ~'~~ ~~~,~ ~ x~ : G .. ~ l S r.. WINNEBAGO COUNTY, WISCONSIN, LAND TITLES ~ T AST ®E TITLE T® Lot Eighteen (13) and the East 1/2 of that part of an alley (now vacated) lying west of and adjacent to said Lot Eighteen (18) and between the extended f•Jorth and South lines of said Lot, all of 5iock Eleven (11) in SECOND ADDITION TO THE PLAT OF THE INTER URt3AN LAND CO., in the Fifteenth Ward, City of Oshkosh, subject to rights reserved to City of Oshkosh as more particularly set forth in Resolution filed on April 20, 1973 as Document No. 433191. ORIGINALLY a part of the East 1/2 of the South West 1/4 of Section Twelve (12) Township Eighteen (18) North, of Range Sixteen (16) East. .. --~ ~~Ac.T NO. 79-1097 SINCE May 8, 1911 at 4:45 P.M. • ,f ' , •~ ~ t' ~„ • 1 .`.~{~.~~''~_ .~:_~.~'~..'.~'.~-'){' ca,;ii'irla~;~cii r.Sh~cl~„/~,~ir t'/i~.r•t_{!:,{t•~(. • r~{ tcT+,.... 1. ~ ;j /~~: . , r { ' .,___ ___.-____ _-_.__._ FAT t~ : ---`-~-1(t.,~ ~ .__. r;Ef d E' I . --- ---~`~ f ; _ _ 1~:itc' ~`uj(lrt:.^. ,,. f~_~~~.a'~4~'_R+~ ~ -- $L'3LC `' ~ `~___-_._._--- _-y_ `---.-.._~._-_--- I)ra J or : ~+ •J.~7b.. ~.Jr_~s~ ] tT t ed ~- ~ ` -~--------t ~' n_'i -- ~--- ~:£t].cu }'. {SIC1~.- ~.'__~-I 1.1.1.15) ,'lppraved Per: Ex~'. ~ Z.5 ---- _ Inil-ia]. ~ ~ ' _.._ ~I Ch.:tnl;e .Order _ ___._ ,~'- ;~ Fi na J. ,~,,,, y (S I~, ) U--value 11 ;: A , > ~~,; ~ !~ .v,~ ~ ___....._-I o co Insul-. A~idrd In;Itlation ~--- -"-' ~ r r '1"ea ~+l)" S t ;:,~.d rTrci - - }• •~ FzBGLipc~ r"uldea l:nsl>l,ttian ~ -~ ~`- ~i ~ Are:. 1f~/ ( Standard "•`"•"" ' '~~ Uther -- f ___l.y~~s?..~ .117 I Z, 3~_ ~ , r~ 2 A~,era^e U-value (U x ~tl,/(A) Froth Lir -_.__ _ 3 Rc~qui~red L' ,vc•.lue ~ _ / /~ ~?/~ ~ / - 3 ~~ w , ..._.._~ g , O U _ . 4 ____ ~ ti Z . t_ _ i --~---- picture -~ .p ~ ~ .~_ ____..w ~_ o Patio 3. o o .......~5.=..~ Z- 0 to 0 t. h Fr. ---~----- --... ,-•....... - ~.. ~ Other ~. ._ cr __ .~ ~ ~-Insu?-ated Are~~ (3~%) ~ ------- .._..__._ _ ~v' `~ l~raTni.nr Area (1~%) ""' •0`'S 3-f~' IS•- o i:i;<<, Joist ~- - 1 Z yv 0!ifi ~n~5~ ~ w „[1 inn d ~•a s ~l , fu x 3 v _ e - - (T 1 I Z , $ r....,t.~ ~.~....- .,..~ :. ~ ~,.,... o - --•--'------ -, 7 S T u 12 ~I B O O _ . (D 2_~ _____ Q r ~.~_-- 1)oors ~`~ Oth.~r }+ .--t _ r------- - -- c~ ,-~ _._..._.__._._.. v ro Other j o }:oilndati.on :da] 1. (Above Graclc~) C,N ~/,'cTV2~ T3Co•0o ~, 14s _~- 19~.._ , Q t hE~r ~--- 4 Totals _JZ $2.8 _'~~ ~ ~f: ~~-'&~.. 5 Aver•t~e U aloe=y~~~~~--. l.~-"~ ~ / : _1~.i~.'~13Z ~---1__,t~,~...~1 6 R e u i r e d is ~~;t 1. u e ~~~~~_~~ ~~ ~ ~~ ~~ / j % ~. i ' Required lI-value w ~ / /~~~~ _ ~--/ j^ +f~i'c~s ~ Area ~~G nr~ will S ~ ~~o '.'- ,-' ~ _ ~~~~- 7'T 0, a o -- , I U D y ,~_. -- ~ / _7--~.-..~,. I r o- ! 11~_~ :~• e t' ~ '. ~ e i'- v a ? u e U '~) / ~.~' - --r-- _~:-...% _ 1, -- o as -- .- ---____ ( :; ~ (A) ~ r or.f L i n c4 I c 1~ / j / % / ~ ,' ' ~' / , _icn ~L :' Rc'cltl~i ri`.I ' 1--va l t: ~ -- i % /~=/- -- - .~_..1 -~ --- C.._.~ ...__.. If line 7 is s•.•cater th.~T~1 Lin('. 3, or 5 is ;~;•I~;ttc7• th:Tn 6, cr-`8 is ; rc,*t+~r than 9, or J.iItC' ~.~ lfi t't'(' !LC'1' t~t~ln ~.~, c`O;".`J E`; (' 1"t+~ ~ 1` 1 Y.'1T1 t n' V+,I(~T,~ l i1 -; ~~•t _h..~il '' ~%-1 !1Cy ~-1 ~1!~il ( ~ 1 It ~ l~ 1 ~ 1 + - ~ ~ + ; . .i a-I _"'!°~. 1 _~_~.~..(~_ \ _ t~-).'_'?_I_I:1_._tl _111 +).--(-C1 ) ---- ^-_ --~; III; 1 .- " ~i. .i , Ii, i I +, ~ I ~ ~ ~ I{{ JJ --- .__.. ... J ~ - _...-,____._ 1 _ _ _ .. _ __ ..._...- ... 1 .~ / ~ _ . t sTnrlDnl;D ti•roHKSrr~cT ~~. ~ ~a r' tlf"f,r' L0~`;/I-UI;rJACE SI ~ING C;\LCUI_n•i'IONS 'r ..: ,.. .~ `' .. .. . ,. ,.. ", ;. Dealer: ~alr~?,~'t^'t~~ ,,~ Fab y!1, ! Date. TOTAL ifEAT LO55 (BTUH) _ (House Loss) + (Infi 1 tration) •-- (Ventilation) •'- (:'clo~•~ Grade Loss) j . ( QT) _ ~•1'rtie~ttempe'rature ~ti fference bcttilecn the interior design temperature and the exterior design ternpcrature. ) ~ o int. Temp. ~~ F - Ext. Temp.. _ ~~,~ of ~. QT f•+`S" o (,,Tbl =;Thf: temperaC~~re difference 6et~.~reen the interior design temperature and the average ground ternpcrature outside the foundation ~~~all. Avg. Temp. =~ 40° + ( •- /$" ) Ext. Design Temp. - ~ ~~''~ ~~ 2 Int. Temp. 7~ °F -Avg. Ternp. 12.5 of = QTb ~'?• mouse BTU Loss: (U x A) =The sum of lines, 1, 4, and 7 on the State Energy Code Compliance Work- . sheet. Line 1 Sz.z~Z + Line 4 ttorr.$Q + Line 7 n Zzz.it~Z BTU Loss = (U x A) (pT) = U x A -~z-z,rc,2 x OT ~S = g, ~~ BT~t; Infiltration: One air change in the house per hour + bsmt. air change (.25; .50; .75)~ (cu. ft. living space) (1,T) (.018) q I Above Grade: 1 x Cu. Ft.. 7~izo x LET: ~ x .018 1 L, 118 BTU'. '~ Below Grade: x Cu. Ft.: ~~yp x OT: $S x 1018 Z, 9(0~ BTU: Ventilation Air: Fresh Ai r~ 25 (or 100) CFM or: (zS CFM x 60) (DT) (.018) iSrw xl~7 85 x_;018 Z, 2 rS BTUH Duct Loss: (Unconditioned Spaces) BTUH Carried to Duct x Loss Factor o BTUu Foundation Perimeter BTU Loss: (WI Only) First 3'-0" Below Grade BTU Loss = (U x A) (L~Tb) = (U x A) Line 10 y4,o(a xQTb 5_-__?,~ Below Grade Foundation Wall:. (Conditioned Spaces -.Less Foundation Per- e imeter Loss) , '. ~I Construction "U" Value Area (Sq. Ft.) OT r CONC ~ Z 7 Ui __l~.t TJ.~~ ~..._ 7' Basement Floor loss: (Conditioned Spaces) "U" Value •,pZ7 x Area (Sq. Ft.) lo5c~ xQTb $~~~_ 2, 5 3~ BTUH ~~y ~~ BTL'", (j BTL-: = BTL' TOTAL HEAT LOSS: _ `J Ca 1'~____ BTL'-' FURNACE S I ZF. ~`''~ Total BTUH Loss + ~_ ~ Allowable Oversizing Limit - Allowable Furnace Size Selected Furnace Input .rfi`~iQy B1~ Model Number ~a:.j~•__;•?~r'_°_.'~_''..._ _,_~d.. Output .~.-L:~u~-~- BTI:: Fuel wl,~Q-t" '~'~P1ote: t•lhen sup;:lied `~, 4;ich Hom.~s, the furnr,r-.~• ~~, ••'t~)1 n:~t~. ~~x.e~~l r. `,^ calculated hezt for?$ plU , Illy. . ~il?.C'_ Q'Jt'I'_ 1 ~.InCt 1 If'll t, ,:~ t; ~`I f~! r I. t: C' ,'JI.. ,.'flt IS aVilf 1c7b1° ~r':tll lllrl ~il;jr r' ~,I ir,, 1, i~C'r:t:l•(l) (.(i(T17-, .. , ,., i'` Crr. I.IF,I !r _ lilC apr)rUprlat" s i ;~e d i i cond i t i ~~n~+ r. ,~ ~.---- r: • STANUAftD ~410i~KSNCET :~~ •a i '~~.A4 ~ "~ ^:~}°~.-,, ": ti p l 41 rl Cv Cub U'~t, vdD ~' ~' I{[{';•y' LOSS/FURt~IACE SI SING CALCULATIONS A>:cca,ctotYK,kE)w~d~n, ,sc~;~„s,r~. ,,~_; Fab: ci (! 1 Date: Ls:°r'P-8"r (Swne r : ~~ ~, _~ Dea 1 e r : C`ra ~.~ ~ r~.'C~ r~ ~ __1__.~__-_ ~~. ' (BTU(H)i= (House Loss) (Infiltration + Ventilation) + (Below Grade Loss) TOTAL !{EAT LOSS + ) ( (QT) _ ~"fhe'tempe'rature difference between the interior' design temperature and ~;the'r exterior design temperature. 1 I' ° Q ~n~:. .Temp. ~ of -Ext. Temp. "/~ F - T f3~" (~~,Tb) ~ ;~'he temperature difference between the interior design temperature an~i the average ground temperature outside the foundation ti•1a11. Avg. Temp. 400 + ( ^ /~ ) Ext. Design Temp. _ / ~~~' 2 Int. Temp. 7Q °F -Avg. Ternp. 12.E °F = L1Tb, S~._S ~ - t. House 8TU Loss: (U x A) =The sum of lines, 1, ~+, and 7 on the State Energy Code Compliance Work- ' sheet. Line 1 Sz.2n2 + line 4 tt~4.$g + Line 7 -_ _ -zz2,rt,z _____-- BTU Loss = (U x A) (QT) = U x A -r_ZZ,rt~Z x QT $S_ = 8, $~ BTuH` Infiltration: One air change in the house per hour + bsmt. air change (.25; .50; •75)~ ' (cu. ft. 1 iving space) (!,T) (.O18) Above Grade: 1 x Cu. Ft.. ~Q x DT: ~ x .018 ~ _ (2.,118 BTUH` Below Grade: ~ x Cu. Ft.: ~~'ip x DT: $S x •018 = Z+ ~p j._. BTU'r; Ventilation Air: F.r..eisih~Ai r @ 25 (or 100) CFM or: (z~ CFM x 60) (DT} (.018) ~Sw xQT $S x ;C-18 = Z~ 2SrS BTUH`.. Duct Loss: .(Unconditioned Spaces} . ' BTUH Carried to Duct ~ x Loss Factor __ _ ~ BTU!'{' Foundation Perimeter BTU Loss: (W1 Only) First 3'-0" Below Grade - BTU Loss = {U x A) (L~Tb) = (U x A) line 10 yy,o xpTb S~,S = Z,53'~ BTUH .Below Grade Foundation Mall:. (Conditioned Spaces -.Less Foundation Per- . imeter Loss)- _• Construction "U" Value Area (Sq. Ft.) LET r " C o N C 2 S 7 Y~4.~,_. •..... ~. Cs.~4P~~ BTI~H': ('j BTUii Basement Floor Loss: (Conditioned Spaces) • "U" Value •,pZ7 x Area (Sq. Ft.) loSt4, xQTb ~2:.~_ .-~~e.~--- BTI±~ TOTAL HEAT LOSS : _ `~ Co,~t I'1 _BTUH , FURNACE SIZE `~'~ • Total BTUH Loss + ~^ ~ Allowable Oversizing Limit = Allowable Furnace Size Selected Furnace In ut ~"~ Model Number L ~-'~,~'~ ~~ 4>,','? ~!~"^~•~~, Output _~~y~- BTUr Fue 1 h.: o ~" ,. - ` ~hai1 not ex;eed r.h~ calculated heat ., a r , a ~~~~ ~~-~ ~~ n ~~P~ote: Gl};en sup,~l ied ~y ~+ick iom~_s, the furn.~r_c; z loss plus Chi:: state over sizing limit, w4~~rre~:er ~;opr•o; riate e~;ui;~r-~ent is available riate from the Si;~~er Clir,~~.~~. Control Company, or t~ bra co~~~;tible ~.,ith the approp ~;~~- s i ze ~, i t cc~nd i C. i ~nE~~. ~ ~~ ~. /~~~?y~ . _ .._ •.~~,:_. __. 1. JA rl t, !! ':5111:!:1' IA'1 F y!_,' .?~.1' t;,_!-i)i' (;U;_fl'i~IItiNCt s:~.t~ Adare~t~: ln, ~~„~ Dialer: _~ ~ ~ _~ Approved Per: _ .^_ ~ ~ Initial .._ _. _ ~.` .~ t ' 1I `P `N q'i ~hl ~ J} ~, ~ fl :~l~n,.'w i of ',\h t, l+uJi'un): s..tt m;, InC. 4t?0 1'.,Zt I iai It0l.U 1'.O. t t~h SSA ~ Uif17.'C)I~1/t(~iC, ~rliSCGI'!SIIJ 5;t f Fab : u 1 0 ~.~, 1`iod c'1: _. M ts_~v l.s, t_ E': _.__._.___ State : l,~~.__.. 1~ a t e : !„~ _!~- ~c ._---- Calculated iiy: ~lcN__(~!~G-l..tatJD _ Ex~ . ~T,3' Final '' ' Area (A) ~~~~ ' ~~ Acsembl.y --- - - - ' -- (S F.) U-ti'alue U ~: A ~ ~ u ~ s'1::'.I.~.~ tcd :1res 90;!) -_-- (14~ ..~...a..-.~ i '~ ~ Pramine ~:r.>a (lOSo) ,Ocj~ r c n Insul_.~ Added Insill.ation _.r... !~ a ~ a +~ •~ `~ :\rea 90` ' Standard _ ~~SO,y.po .042 3 ~ ~ ~' ."~ ' ; o Fra'il-_il Added Insulation . a ~` ~ rl ~ v Area 1G% Standard o . to .11.7 I Z.35 S ~~ al Uther °'"'" 1 Totals 2 1?vein^e U-value (U X A),/(Al Fro3~ Line 1 / ~ ,~, , p / / // / 3 Required U^ value / f ~ ~~ .p'~ c'fi ~ ~ / i / .____ __~___.__.~._...... ~ S 1 i ci e : s a $ , o c5 _~ , y g ~ sy~, Z Ly l sow ls~y •~ Picture _ v; ~` Steel 3 .on ~ .~ ~_......,,5~2 U Patio O ~ _.__ ~ Other. '~~~ ~ Other -- -- - .>`; ~ ' `" ~ lilsu:iate.l Ares. (35%) _ ~ .0,5 ~3f3~.~~._.._ ~, ~u - ~= t~ rani nJ; Area (1~%) f Z z, y ~ .086 r v~ S 3 o ~. i:i;~,~~ Joi - s t e- t l -1 z,~ ~_______ ._.....cd ~...._ _ ._2_~ t f •~.• ~j t~~i~r.do~a~ LJ _ - (o x37 '"~i STu.2 .~ ~I10b te,~ . Q 3 . r~ o ~ Loors ,`, r, Other -.__._~,,. ro ~ Other. rt ~ _ Foundar_i.on Wall (Above Grade) Ccu~'"/i~STy/Zp -- --~ ~ ~~~ _ e Iggt? Other 4 Totals JZ 2t8~' ~ ---~ / % ~ f%~ I(aQ~RY 5 Aver<aRe U aloe ~"~ 'N Ig~' -~ ~ ~ ~ % ~ ~! ~ 3Z ~ / i' % ~. RE? 111rP.d ~ \ra 1.-ll(' ~ , ~ ~ /~L_ ~~ 1, _._.:! •.A_._~_ , ~ ~ / / ' ~ o ~ sTetE ~~~:~L~.~t~~~ ~. ~__... .~.,.~..~. r .. i~ ~ so cd ~ ~ i ~ ~~r ~ 9 Required U-value % / / ~ % 4 .~-c~s ~ Area c c, ~ t, w/i ~~ S r:,! Jzo ~~"o , 4 O •~ ! U ~I , o ~ - ._____ ~ Q,~ 0 10 7'u t a i s ~.,,....'..' .""4..7`x` ..~..._.-, ~ ~ r c• ._ 11. ~' ~ et _~c. i'-v31 ue (U x A) / (A) ~ rom I.ir.e l i) , ~ ~ ~ ; / / / ~ c:, ~1.«~ ~J_}_.~'(I1t71~t`:I_'t_1~1~ is - -~..._ / i ~ / i ~ ! ...a.~.~... ..~ ...~...1...~..:......C L~:_.. ~...._. :._.~.-..- ....~.. __- __ __ ~ If line 2 is t;.•eat,r thrtn li-ic 3, or 5 is ~ dater. than 6, or S is ;renter than 9,~or line 11 is ~•i ~.?ter than 1?_, co^,;,lete t~,e f~,' l main ~ to'~al env~l~-~~ r^t't ~3od. ' _ `...._ 13 ' ' ~{ ~`,~Y T i .~~ GaX S7. i t' ~l~ittc 1~IQ.,-)1 (!1_T~f~' ;:3, ~_'1.~ ~ r',\ ~~ Z,r ` ~- ZIt~F("t !;'i~hi`~ ! y ~ ~ r~ l%:lll1 ~1;/ ~~'_. ~z ~'_j ~ , '_) \ t` v~3 l t-`---t~ 411 e..._..'.'.~. .~_ ~ ! J ' ! ? ? ' ~ '~ _ ~ _ ._ __ .._...__-__ _..~._.__ , i ~ .___ --._.___.... _.._. ~ _ t i u~ t l: / 1 S_~ ~ 'll _._ _ ,...., .,....... ,.............., ~... .., 1 i l ` ' ~ i i. r `u.~_ (I,i ~ 1 ~, I t l , c I ( -f 1 7) ( -~ _. _._ .-___~.__~.___ -----.__r__ _._. _ _ .- . ' .. . __.. _ Y - • __ _ - ` 1 ; 1 ' .; t '.','~_ ? i i'1~ ~`~;;ti'; i <t.,.Sc 111111 ,, 1 i~i .i . ' il! l f:, ."31 L C'Y Tl(~~ . .i f -~3 dt?l': .......__..~.-..Y.~.`-_ - trz.... .,. Change.Ordcr BTATE OF WISCONSIN DE~NTrlEUOO~DUaTnv,ueonAND WISCONSIN UNIFORM PERMIT NO. ~~~~~~ DIV181ON OF 8AfTV AND BUILDINGS o1X~ 1NCTONAVE. BUILDING PERMIT PARCEL NO WI8CONSIN STATUEB 101.81 ""A°"°"~W'~~"°' APPLICATION . PERMIT REGIUESTED CONST HVAC LEC ^PLUMB War's Name Mailing Address /"" Telephone C tractor's dame Mailin Ad ss °In 9 ~ Telephone PROJECT LOCATION 1 v. ~., SECTION , T N, R EIorIW Building Address 3 Subdivision Name ~g / D Lot No Block No. 3 _ t .. `.,, ~ ~ ing Dis ict Lot Area Setbacks Front Rear ~ Left ~ Right - - Sq.ft. ft. ft. ~ ~ ft. ~ ~ ft. 1. PROJECT 2. TYPE 3. ELECTRICAL 4. HVAC EQUIPMENT 5. ENERGY S OURCES Entrance Panel Space water ~Vew ^Addition Sin le famil Forced Air Furnace Fuel Ht Htg. o g y Size: ' ~ © ^^"P ^ Radiant Baseboard or Panel ^ Alteration ^Two family Service ^ Garage ^ Other ^ Underground ^ Heat pump LP Gas Q ` ~ ~I. ^Boiler Nat. Gas ^Attached Overhead Fuel Oil ^ ^ ^ Detached ^ Central Air Cond. ^ ^ 6. CONST. TYPE 7. FOUNDATION ^ Other Elec. ^ Other Wood ^ ^ ^Master plan no. ^Site const. Concrete $ PLUMBING Solar ^ ^ , (if applicable) anufactured Masonry Coal ^ ^ ^Treated Wood Sewer Other 9. AREA outside 10. STORIES Dirrwmion ^ Other ~unicipal ft. ~1-Story 11. USE ^Septic ^Basement ~~7o sq . ^Permit No. 12. WATER / ~j ^ 2-Story ^ ~ ~ Living Area ` ° b sq.ft. ^ Other easonal ermanent ^ nvate ^ Garage sq.ft. ^ Other ~unicipal e applicant agrees to comply with the Wisconsin Un orm Dwelling Co d other Municipal Ordinances and with the conditions of this permit; un erstan s that the issuance of the permit creates no legal liabil" ,express 'mpli on the a tme Icipality; and certifies that al the above information is accurate. SIGNATURE OF APPLICANT DATE V CONDITIONS OF APPROVAL This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or revocation of this permit or other penalty. ~ 3. ISSUING JURISDICTION ^VILLAGE .F~'6~TY ^TOWN ^COUNTY ^ STATE / NAME - ,~~~~/~L MUNIC. NO.Z~ - ~ ~U FEES PERMIT(S) WIS. UNIFORM PERMIT ISSUED SEAL NO.IS) PERMIT UED BY PLAN REVIEW $ ... ~CONST. d ~ INSPECTION "_ WIS PE ~ , VAC " NAME ~.-.29.. . RMIT SEALIS) _ ~ LEC ~ • DATE OTHER ( 1 r TOTAL $ ^PLUMB / CERT NO. ~~ ~.~•+ DILHRSBD-5823 ISSUING JURISDICTION/AGENCY ~ a i OWNER ~~l ~ [:~~~ ~:.~.~ ADDRESS ~===~.~ ~~ `r ~~~~ ~, T°' ' DATE ~~ '~~ % " ~.Y~% PERMIT # ~D'.~S` USE ~~~/~ - r ~( _ Woz k consists o ~-e-u-~~ - `~ ~ Q~~G~~RAL CO CTOR ~G~-~ ,~-c'~ ~ MAS N CO RACTOR ZONE ,~~ Width of lot,,, n v O w O a m a '~ (~' ~ ~~ .. Front of lot E~~~~~ INSPECTIONS REMARKS MAILING 1K~7DR~ss